Diagnostics (Mar 2023)

Ultrasound Placental Remodeling Patterns and Pathology Characteristics in Patients with History of Mild SARS-CoV-2 Infection during Pregnancy

  • Adelina Staicu,
  • Camelia Albu,
  • Georgiana Nemeti,
  • Cosmina Ioana Bondor,
  • Dan Boitor-Borza,
  • Andreia Paraschiva Preda,
  • Andreea Florian,
  • Iulian Gabriel Goidescu,
  • Diana Sachelaru,
  • Nelida Bora,
  • Roxana Constantin,
  • Mihai Surcel,
  • Florin Stamatian,
  • Ioana Cristina Rotar,
  • Gheorghe Cruciat,
  • Daniel Muresan

DOI
https://doi.org/10.3390/diagnostics13061200
Journal volume & issue
Vol. 13, no. 6
p. 1200

Abstract

Read online

Introduction: This research aims to describe a progressive pattern of ultrasound placental remodeling in patients with a history of SARS-CoV-2 infection during pregnancy. Materials and Methods: This was a longitudinal, cohort study which enrolled 23 pregnant women with a history of former mild SARS-CoV-2 infection during the current pregnancy. Four obstetricians analyzed placental ultrasound images from different gestational ages following COVID infection and identified the presence and degree of remodeling. We assessed the inter-rater agreement and the interclass correlation coefficients. Pathology workup included placental biometry, macroscopic and microscopic examination. Results: Serial ultrasound evaluation of the placental morphology revealed a progressive pattern of placental remodeling starting from 30–32 weeks of gestation towards term, occurring approximately 8–10 weeks after the SARS-CoV-2 infection. Placental changes—the “starry sky” appearance and the “white line” along the basal plate—were identified in all cases. Most placentas presented normal subchorionic perivillous fibrin depositions and focal stem villi perivillous fibrin deposits. Focal calcifications were described in only 13% of the cases. Conclusions: We identified two ultrasound signs of placental remodeling as potential markers of placental viral shedding following mild SARS-CoV-2. The most likely pathology correspondence for the imaging aspect is perivillous and, respectively, massive subchorionic fibrin deposits identified in most cases.

Keywords